Cognitive decline is recognized as a prevalent and debilitating symptom of multiple sclerosis (MS),1 with cognitive changes often occurring early in the disease course.2 Even relatively subtle cognitive decline can have substantial real-life consequences, including negative effects on employment3 and quality of life, both for people with MS and their caregivers.4 Heightened awareness of disease-related cognitive decline has motivated cognitive screenings as a key component of comprehensive care at clinical MS centers; however, increased awareness and clinical attention has also highlighted the lack of effective symptomatic treatments for cognitive deficits.5,6 Obstacles encumbering validation of effective treatments have been discussed,1 including a lack of methodologic rigor in clinical trials aiming to improve cognition.5,6

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